Provider Demographics
NPI:1376750257
Name:HENRY GONTE, D. O. F.A.C.G.P
Entity Type:Organization
Organization Name:HENRY GONTE, D. O. F.A.C.G.P
Other - Org Name:MARTIN M SOLOMON, D. O. P. C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:D O
Authorized Official - Phone:734-729-1150
Mailing Address - Street 1:30141 CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-4019
Mailing Address - Country:US
Mailing Address - Phone:734-729-1150
Mailing Address - Fax:734-729-1807
Practice Address - Street 1:30141 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-4019
Practice Address - Country:US
Practice Address - Phone:734-729-1150
Practice Address - Fax:734-729-1807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101007856207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty